1871 CORRELATION OF PRE-OPERATIVE ABDOMINAL LEAK POINT PRESSURE WITH POST-OPERATIVE STRESS URINARY INCONTINENCE AFTER CYSTOCELE REPAIR AND SLING

Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Female Urology II1 Apr 20121871 CORRELATION OF PRE-OPERATIVE ABDOMINAL LEAK POINT PRESSURE WITH POST-OPERATIVE STRESS URINARY INCONTINENCE AFTER CYSTOCELE REPAIR AND SLING Sam Kuykendall, Sharron Mee, Gary Leach, and Maggie Vuturo Sam KuykendallSam Kuykendall Los Angeles, CA More articles by this author , Sharron MeeSharron Mee Los Angeles, CA More articles by this author , Gary LeachGary Leach Los Angeles, CA More articles by this author , and Maggie VuturoMaggie Vuturo Los Angeles, CA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2025AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES It is unknown if the severity of stress urinary incontinence (SUI) on pre-operative urodynamic studies correlates with a patient's likelihood of persistent SUI after cystocele repair with sling. No previous studies have evaluated the correlation of pre-operative abdominal leak point pressures (ALPP) with incidence and severity of SUI after cystocele repair with sling placement. METHODS A retrospective review was performed examining 420 patients who underwent cystocele repair with simultaneous suburethral sling. All patients had both pre-operative urodynamic studies (UDS) and follow-up with a validated incontinence questionnaire. UDS were performed in all patients with and without reduction of the cystocele. All patients underwent sling placement regardless of pre-operative UDS findings. Sling types included transobturator sling, single incision sling and cadaveric fascial sling. Presence and severity of patient SUI was self-reported in a validated questionnaire post-operatively. RESULTS Of 424 patients analyzed who underwent cystocele repair and sling, 185 demonstrated SUI on pre-operative urodynamic studies. The remaining 239 patients did not show SUI during pre-operative UDS. There was no detectable difference in the proportion of patients with or without post-operative SUI in any of the three groups with pre-op SUI based on pre-operative ALPP (p=0.67 for LO v MID or HI v MID; p=1.0 for LO v HI). We estimated the 95% confidence interval for the difference to be ± 18% (LO v MID or HI v MID) and + 22% (LO v HI). There was no statistically significant difference between the three groups when compared to the 239 patients who were dry pre-operatively as well. Additionally, ALPP did not correlate with post-operative SUI based on sling type. CONCLUSIONS Despite suburethral sling placement at the time of cystocele repair, some patients experience post-operative SUI which is usually reported as mild. There is no evidence for a direct correlation between ALPP on pre-operative urodynamics and the likelihood of continued SUI after cystocele repair with sling placement. Incidence and Severity of Self-Reported SUI after Cystocele Repair Based on Pre-op ALPP Preop ALPP <50 (75 pts) Preop ALPP 50-80 (70 pts) Preop ALPP >80 (40 pts) PreOp ALPP of infinity (DRY) (239 pts) No Post-op SUI 46(61%) 42(60%) 32(80%) 218(91%) Mild SUI 19(25%) 19(27%) 6(15%) 14(6%) Moderate SUI 7(9%) 8(11%) 1(3%) 6(3%) Severe SUI 3(4%) 1(1%) 1(3%) 1(<1%) © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e756-e757 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sam Kuykendall Los Angeles, CA More articles by this author Sharron Mee Los Angeles, CA More articles by this author Gary Leach Los Angeles, CA More articles by this author Maggie Vuturo Los Angeles, CA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...